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Front Immunol. 2019 Dec 12;10:2910. doi: 10.3389/fimmu.2019.02910. eCollection 2019.

Gut and Lung Microbiota in Preterm Infants: Immunological Modulation and Implication in Neonatal Outcomes.

Frontiers in immunology

Chiara Tirone, Lucilla Pezza, Angela Paladini, Milena Tana, Claudia Aurilia, Alessandra Lio, Silvia D'Ippolito, Chiara Tersigni, Brunella Posteraro, Maurizio Sanguinetti, Nicoletta Di Simone, Giovanni Vento

Affiliations

  1. Fondazione Policlinico Universitario A. Gemelli IRCCS, U.O.C. di Neonatologia, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy.
  2. Università Cattolica del Sacro Cuore, Istituto di Clinica Pediatrica, Rome, Italy.
  3. Fondazione Policlinico Universitario A. Gemelli IRCCS, U.O.C. di Ostetricia e Patologia Ostetrica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy.
  4. Università Cattolica del Sacro Cuore, Istituto di Clinica Ostetrica e Ginecologica, Rome, Italy.
  5. Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento di Scienze di Laboratorio e Infettivologiche, Rome, Italy.
  6. Istituto di Microbiologia, Università Cattolica del Sacro Cuore, Rome, Italy.

PMID: 31921169 PMCID: PMC6920179 DOI: 10.3389/fimmu.2019.02910

Abstract

In recent years, an aberrant gastrointestinal colonization has been found to be associated with an higher risk for postnatal sepsis, necrotizing enterocolitis (NEC) and growth impairment in preterm infants. As a consequence, the reasons of intestinal dysbiosis in this population of newborns have increasingly become an object of interest. The presence of a link between the gut and lung microbiome's development (gut-lung axis) is emerging, and more data show as a gut-brain cross talking mediated by an inflammatory milieu, may affect the immunity system and influence neonatal outcomes. A revision of the studies which examined gut and lung microbiota in preterm infants and a qualitative analysis of data about characteristic patterns and related outcomes in terms of risk of growing impairment, Necrotizing Enterocolitis (NEC), Bronchopulmonary Dysplasia (BPD), and sepsis have been performed. Microbiota take part in the establishment of the gut barrier and many data suggest its immune-modulator role. Furthermore, the development of the gut and lung microbiome (gut-lung axis) appear to be connected and able to lead to abnormal inflammatory responses which have a key role in the pathogenesis of BPD. Dysbiosis and the gut predominance of facultative anaerobes appear to be crucial to the pathogenesis and subsequently to the prevention of such diseases.

Copyright © 2019 Tirone, Pezza, Paladini, Tana, Aurilia, Lio, D'Ippolito, Tersigni, Posteraro, Sanguinetti, Di Simone and Vento.

Keywords: bronchopulmonary dysplasia; growth impairment; gut microbiota; gut-lung axis; late-onset sepsis; lung microbiota; necrotizing enterocolitis; preterm infants' outcomes

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